Quality Improvement Specialist (HEDIS)

Location: Remote within the United States; must be authorized to work in the U.S. without employment-based visa sponsorship

Salary: $56,200–$101,000 per year

Company

hirify.global provides healthcare services focused on improving access to care and health outcomes for individuals, families, and communities.

What you will do

• Support quality improvement projects for HEDIS Hybrid Operations and the clinical aspects of medical record review.
• Train providers, health plans, and staff on continuous quality improvement, HEDIS abstraction, and over-read processes.
• Provide clinical support for medical record abstraction, over-read, and audit activities.
• Monitor contractual quality indicators, analyze results, and track performance trends.
• Develop and implement performance improvement plans using the PDSA model and monitor them through closure.
• Participate in meetings with committees, state agencies, providers, health plans, vendors, and other stakeholders.

Requirements

• Bachelor’s degree in Nursing, Healthcare, or Quality, including HEDIS measures or NCQA, or equivalent related healthcare experience.
• Experience with HEDIS, medical record review, quality improvement, or related healthcare activities.
• U.S. work authorization is required.
• Employment-based visa sponsorship is not available now or in the future.
• A valid state clinical license, such as LPN or RN, is preferred.

Culture & Benefits

• Remote, hybrid, field, and office work schedules are supported, depending on the role.
• Health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off, and holidays.
• Compensation may vary based on skills, experience, education, job-related factors, and employment status.
• Work focused on improving healthcare accessibility and effectiveness.